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NDMM at EHA 2024

CME

Experts Discuss Advances in Newly Diagnosed Multiple Myeloma: The Impact of More Intensive Therapy on Clinical Outcomes

Physicians: Maximum of 1.50 AMA PRA Category 1 Credits™

Released: September 17, 2024

Expiration: September 16, 2025

Michele Cavo
Michele Cavo, MD
Christopher R. Flowers
Christopher R. Flowers, MD, MS
Francesca Gay
Francesca Gay, MD, PhD
YuQian Liu
YuQian Liu, PharmD
Greg W. Mattingly
Greg W. Mattingly, MD
Paul G. Richardson
Paul G. Richardson, MD
CME/CE Information

Pretest

Progress
1 2 3
Course Completed
Please answer the questions below.
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1.

Rate your level of agreement with the following statement. I am very confident in my ability to identify patients with NDMM who are most likely to benefit from a CD38 mAb-based quadruplet regimen.

2.

Patient Case: Newly Diagnosed Multiple Myeloma



  • A 55-yr-old woman with no significant past medical history presents with worsening lower back pain

  • Initial evaluation includes plain films that show multiple lytic lesions in the vertebrae with an associated compression fracture at L1; initial labs are notable for Hb 9.8 g/dL, albumin 3.1 g/dL, total protein 9.0 g/dL, serum Cr of 0.8 g/dL, Ca 11.0 mg/dL

  • Additional evaluation

    • SIFE/SPEP: IgA lambda monoclonal protein 3.5 g/dL  

    • IgG 400, IgA 3700, IgM 20, kappa 5.1 mg/L, lambda 267 mg/L, FLC ratio 0.019

    • LDH 400 (elevated); serum β2-microglobulin is 7.1 mg/L

    • PET/CT scan: multiple hypermetabolic areas in the bones with associated lytic lesions

    • Bone marrow biopsy: 45% atypical plasma cells; FISH (CD138+ selected): gain 1q positive and t(4;14)



In your current clinical practice, what would you recommend for this patient? 

3.

In the phase III PERSEUS trial evaluating Dara-VRd and Dara-R maintenance vs VRd and R maintenance in ASCT-eligible patients with NDMM, all of the following are true regarding the addition of daratumumab EXCEPT:

4.

In the phase III IsKia EMN24 trial evaluating the addition of isatuximab to KRd in ASCT-eligible patients with NDMM, which of the following best describes the impact of isatuximab on MRD? 

5.

Patient Case 2: Newly Diagnosed Multiple Myeloma



  • 76-yr-old male with history of COPD (well-controlled) and low back pain x10 yr after motor vehicle accident presents with increased fatigue

  • Exam shows: 

    • Anemia with Hgb 9.7 g/dL

    • Serum electrophoresis: M-spike: 4.2 g/dL, IF: IgG K

    • Bone marrow aspirate: 30% plasma cells

    • Cytogenetics (FISH): t(14;16); TP53 mutation

    • Low-dose whole-body CT: diffuse bone lesions, spine

    • Creatinine: creatinine clearance 30 mL/min; β2 microglobulin: 2.5 mg/L; albumin: 3.8 g/dL;  LDH normal



In your current clinical practice, which treatment would you recommend for this patient? 

6.

In a global analysis, which of the following sociodemographic factors was NOT found to be associated with worse access to treatment for patients with multiple myeloma? 

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